With parents aging and feeling a bit lost, it is time for us to take charge. Here are a few tips on getting started if you have aging parents in India. I prepared this doc while focusing on this task for a few weeks during my trip to Bombay in December 2022.

A focused effort by you

Create a Master google doc where you are developing a plan and capturing important information that is shared with your siblings and parents, It should be the doc where you capture medicine info, bank information - pretty much everything. Write down the objective of your effort and focus areas in this doc and purse them to completion once you are there.

Make time for them. Consider planning a sabbatical for a few months. Yes - you can put your life on hold for a few months for your parents. Be their best friend and I am sure you’ll cherish those conversations forever.

This is the time to also talk to siblings and come up with a plan. If you have siblings in India, they’re your best bet. Take all the help, trust they can do a good job and try not to manage your parents’ life from abroad. Also, having siblings in India doesn’t mean your responsibility goes away.

Be prepared to make a trip to India for at least 3 weeks: We cannot manage it from the US, much as we think we can. Plan your trip for a reasonable length of time to assess the situation “on the ground” and take action.

Have a set of objectives identified before your trip and work with your siblings to arrive at common goals. Focus hard on these outcomes as time will fly once you are there. This is not the time to take vacations or hang out with relatives and friends - focus hard! If you don’t have a sibling in India, this may be the time to discuss which sibling can make a temporary move back - with a passing the baton approach.

Once you are with them, start with change management

Reiterate to parents the importance of health and why they should protect and enhance their health at all costs. Remind them that they are not what they were 10 years ago. Constant reiteration and reinforcement will help.

Parents are used to the home they have lived in for years. Do not make too many changes - such as moving to a new city or a new house or changing to brand new water faucets - unless absolutely necessary. Simple tasks may have become a challenge for them, especially if they are dealing with dementia. So do not disrupt their life with too many changes.

Make sure you make decisions for them - that will work in their interests. If they complain, just make the classic excuse “I am in a time crunch.” Seniors have gyroscopic balance issues when they stand or walk. So coax them to use a walking stick or make adjustments to prevent falls. Parents at this age may get indecisive, but you cannot! So move fast! Rely on your judgment - but check with your siblings.

Remind them of the risk of online banking and possible fraud. Remind them to NEVER share OTT numbers as someone could clean up the bank accounts.

Get local help for your parents

Reiterate to parents the importance of health and why they should protect and enhance their health at all costs. Remind them that they are not what they were 10 years ago. Constant reiteration and reinforcement will help.

Parents are used to the home they have lived in for years. Do not make too many changes - such as moving to a new city or a new house or changing to brand new water faucets - unless absolutely necessary. Simple tasks may have become a challenge for them, especially if they are dealing with dementia. So do not disrupt their life with too many changes.

Develop a master daily schedule for your parents

Seniors are seemingly lost. So help them with best practices. Set up their daily schedule - plan the time for lunch dinner and their medicine schedule. Develop a routine for them and make things idiot proof. Print the schedule, post it on a wall and refer to it as something they could plan their day with. It is important that they have their meals at regular slots. Do not let their schedule go out of whack. This is a list that will revised right until your departure - but compiling such a list will be very helpful for them.

Their health is your #1 priority

Make sure parents are well situated with health insurance - find out the insurance they have and if they don’t have one, perhaps you can purchase one.

Get the best medical professionals in the area engaged to handle special health conditions. Hospitals have the best resources. Meet the doctors - including any primary physicians - and make a judgment call who you will entrust care of your parents at this stage. If parents are fragile, then there is no room for error - so make smart choices.

Engaging with the hospitals or physicians is via mobile apps or Whatsapp, so jump in and take charge for the aging parents. Download the app, setup appointments, help them with online payments and even join the teleconsultation visits. Many businesses just use Whatsapp to communicate with their clients. So make use of this rapid fire communication tool. You will be surprised how quickly businesses respond to Whatsapp. For example - a pharmacy store close by will deliver medications based on simple Whatsapp messages.

In the master google doc, make sure you capture all the medications they use (or use an app), Doctors will often ask for a list in case of an emergency. Make sure you check with parents if they are taking their medications on time. You can do so, only if you have a list of medications they are supposed to take.

This is a booming business in India. There are lots of care providers in your city. The going daily rate is Rs. 600 (attendant) to Rs. 2500.(trained nurse). Parents may resist, but go all out, even being pushy to get them the help they need, if you think that is necessary. DO NOT go DIRECT by employing an attendant directly as an agency will have high availability and failover. If you have a Man Friday - the person would have emergencies, and your parents will be left in the lurch. Make sure the attendant is never bringing friends to your home - that could prove dangerous. The attendant / nurse should arrive solo.

Identify their top health challenge and come up with a plan. Depending on their health - it may be a good idea to have a physiotherapist visit home every month and they will notice any health degradation.

Get them ready for the new world

Make adjustments at home to make it senior friendly: Such as installation of handle bars at key points in the bathroom, sink etc. to ensure parents will get a firm hold and stabilize their balance.

You will need to keep an eye on your parents. Install simple surveillance systems with audio and video. If you have an old camera system make sure to carry it with you.

Help them navigate their smart phone and show them how to get what they need - whether shopping from JioMart or recharging (paying) for the calling/data facility etc or paying for their cable/network. If you have a smartphone handy, take it with you and help with the setup. Set up digital payments on their phones, Paytm, GPay, UPI. Chances are they already have them set up.

Understand their current financial situation

Now is the time to ask questions on where their PPF account is, where are the different bank accounts, find out about their ATM cards, passbooks, online access etc. Add this data to the master google doc.

Time to hone upon a single bank account that is close to home and set up payments through this bank account. Make sure you have online access and keep track of what’s going on. Pump in funds yourself into this account or move funds from other banks.

Everything in India has to be approved with a OTT code. Setup bank accounts, net banking, UPI so that you can get OTP SMS/emails overseas. This way, you can manage their finances, if needed. Most banks allow email addresses and overseas phone #s for OTP. Other option is to get a pre-paid india # to get overseas OTP SMS. Typically plans cost ~Rs 2000 per year. Understand which cell phone has been setup for OTT codes for financial transactions. You may want to use the same apple id / google play id and login into an old phone or tablet so you can see the OTT code.

In case of an issue, where is the source of their emergency cash? Make sure they know it and you know it. Make sure you have a plan.

Get their login ids and passwords - you will need it to reset accounts and have access to them.

Time to get a will in place

Engage a local lawyer for the purpose. Parents get worried thinking about a will - let them know that you have already done one and they should do it too. Make sure all bank accounts, assets, demat accounts have nomination. Make sure all siblings are aware of the will to avoid later issues.

Make it a priority

Most importantly, aging parents need emotional support more than a setup plan, even more so when only one of them is left behind. Biggest service you can do to them is to give them time. Make frequent visits, coordinate with your spouse, overseas siblings, if any. “It’s not possible to be away from work” is a myth.

Think again... Is it really that difficult to take a sabbatical for 3 months? Sounds impractical and emotional but in my opinion, it’s our duty! It’s very much possible if you make it a priority. Fortunate people around us do it. I know someone from this group won’t even meet you as he has to attend to an ailing parent.. I personally think it’s a choice that most do not want to make. If you do, it’d give utmost gratification to you and even more to your parents for rest of life. Maybe your kids will learn from example and do the same when you need it :). Apologies if I sound emotional, but believe me, it’s the reality.